To Örebro University

PURPOSE: Music listening with headphones and at high sound levels is common among young people. Risky music listening may be influenced by behavioral factors, and investigating these could have implications for more effective prevention. The aim is to describe participants' hearing health and music listening habits and explore associations between attitudes to noise and measured sound pressure levels (SPLs) from participants' headphones and between perceived auditory symptoms with hearing and SPL measurements.

METHOD: This is a cross-sectional study including audiometry (0.125-16 kHz), distortion product otoacoustic emissions (DPOAEs), SPL measurements, and a questionnaire. The participants were 10-20 years old. Out of 71 respondents to the questionnaire, 53 also participated in the hearing and SPL measurements. RESULTS: Positive attitudes to noise were significantly associated with higher measured SPLs. Participants ≥ 15 years old had more positive attitudes, higher measured SPLs, and reported longer durations of headphone music listening. Most auditory symptoms were significantly correlated with self-reported music listening habits but not with measured SPLs, audiometry, or DPOAEs. Participants experiencing a greater need for auditory recovery had higher variation in DPOAE amplitude for both ears.

CONCLUSIONS: Attitudes to noise may play a role in shaping risky music listening behaviors. Perceived auditory symptoms may occur before detectable audiometric threshold shifts. Addressing these aspects could promote safer music listening behaviors. 

OBJECTIVE: To describe the methodologies and results of qualitative studies examining cochlear implantation outcomes in adults with profound bilateral hearing impairment.

DESIGN: Scoping review. Study sample: Studies with qualitative or mixed-method research designs published in indexed scientific journals on cochlear implantation outcomes in adults with profound bilateral pre-or postlingual hearing impairment and uni- or bilateral cochlear implant (CI). A comprehensive search of the PubMed, CINAHL, PsycInfo, Cochrane Library, SwePub, and DiVA databases revealed 855 records after duplicates were removed. After screening the titles and abstracts and reviewing full texts, 23 studies were included.

RESULTS: Grounded theory (n = 10) and thematic analysis (n = 10) were the most frequently employed qualitative methodologies. Interviews were the predominant data collection method (n = 19), followed by surveys/questionnaires with open-ended questions (n = 10). Ten domains of cochlear implantation outcomes were identified: Improved hearing and communication, life-changing experiences, changes in personality and identity, benefits for the patient's social environment, employment-related experiences, cochlear implantation outcomes in prelingual profound deafness, music perception, tinnitus, negative experiences following cochlear implantation, and other cochlear implantation outcomes.

CONCLUSIONS: Qualitative research on cochlear implantation outcomes provides a nuanced understanding from the patient's perspective, capturing a broad range of benefits and challenges often overlooked in quantitative research.

Purpose: Research on well-being in emerging adulthood, typically spanning the 20s to early 30s, has received limited attention in individuals with hearing loss. The present study aimed to explore the associations between well-being - operationalized as health-related and general quality of life as well as perceived stress - and age, working memory, and mentalizing, that is, the ability to reason on other person's mental states, in young adults with hearing loss aged 18-35 years, and test whether well-being differed compared to normally-hearing peers.

Methods: In this cross-sectional study, participants were assessed on tests of verbal working memory and mentalizing skill and self-reported perceived stress as well as health-related and general well-being. Forty-one participants, 18 with hearing loss and 23 normal hearing, with a mean age of 26 years were recruited to the study.

Results: The results suggest that young adults report similar levels of well-being irrespective of hearing status. Working memory and mentalizing abilities did not show an association to well-being in either group. Age was found to be negatively correlated with well-being for participants with hearing loss.

Conclusion: The level of well-being might decline in individuals with hearing loss as everyday demands increase with increasing age in early adulthood.

PURPOSE: The aim of the current study was to translate the English original version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) to Swedish, evaluate the translation in terms of comprehensibility and relevance from a patient perspective, and culturally adapt the Swedish version (HFEQ-SWE).

METHOD: A six-step methodology including translation into Swedish according to best practice methodology, evaluation, and cultural adaptation of the HFEQ-SWE using qualitative focus group interviews was used in this study. Thirteen adults with hearing loss were recruited from the audiological clinic in Örebro, Sweden. Their mean age was 57 years, and the four-frequency pure-tone average for the best ear ranged from 5 to 115 dB HL.

RESULTS: The results demonstrated that most of the items in the HFEQ-SWE were viewed as relevant by the informants. Not all items were considered relevant for all people, which also reflect the individual variability of everyday functioning. Most items were recognized as comprehensible without any changes needed.

CONCLUSIONS: Overall, the results indicate that the translation is semantically and culturally valid from the patient's perspective. Some revisions were suggested that need to be addressed in the further validation process of the HFEQ, and one item was removed.

Objective: To assess transient-evoked otoacoustic emissions (TEOAE) data from 15 years of a newborn hearing screening program and evaluate how well various criteria separate ears with and without hearing loss.

Design: Retrospective review of TEOAE data using logistic regression, receiver operating characteristic curves, and cumulative percentage graphs.Study sample: Children with hearing loss who passed TEOAE screening as a newborn were compared to children who failed TEOAE screening and normal hearing children who either passed or failed. Exclusions were applied for acquired hearing loss or auditory neuropathy.

Results: Ears with hearing loss that passed screening had significantly lower TEOAE response levels compared to ears with normal hearing. Noise levels, test times, and number of sweeps were also lower. Most of these ears had mild hearing loss. Logistic regression results showed that high-frequency TEOAE response level is the best predictor of hearing loss. A multivariate "logit" score calculated from the regression was the best indicator for separating ears with hearing loss from ears with normal hearing.

Conclusions: TEOAE response levels or an algorithm which incorporates logit scores should be considered as a minimum passing criterion to increase the sensitivity of the TEOAE screening.

BACKGROUND: Preschool children are regularly exposed to high noise levels that may affect hearing. A previous study has linked preschool noise exposure to reduced distortion product otoacoustic emission (DPOAE) amplitudes. Since DPOAEs primarily reflect outer hair cell (OHC) activity, they provide an indirect marker of cochlear function. Measurement accuracy can be affected by middle-ear pressure. Pressurised DPOAEs (pDPOAEs) compensate for middle-ear pressure during recording.

METHODS: This cross-sectional study aimed to examine the relationship between preschool noise exposure and pDPOAE amplitudes while accounting for middle-ear pressure. Seventy-five children (4-6 years old) were monitored using dosimeters to measure the equivalent continuous sound level (LAeqTi) and the 95th percentile of maximum levels (LAFmax,95). Of these, 56 children completed pDPOAE testing at four time points during the preschool week. Linear mixed-effects models evaluated associations with noise exposure, time of day and progression across the week.

RESULTS: For personal dosimetry, the mean LAeqTi was 80 dB (range: 60-98 dB) and the mean LAFmax,95 was 97 dB (range: 77-110 dB). Most LAeqTi levels (86.2%) were between 75-85 dB, with LAFmax levels exceeding 115 dB in 53.8% of the cases. No significant associations were found between LAeqTi or LAFmax,95 and pDPOAE amplitudes (p > 0.05). Time-of-day differences were observed, with higher amplitudes in the afternoon at 4 kHz (p = 0.045) and 6 kHz (p = 0.047) in the right ear, and 3 kHz in the left ear (p = 0.021). Girls showed higher amplitudes than boys at 4 kHz in the left ear (p = 0.030).

CONCLUSIONS: Although pDPOAE amplitudes varied with time of day, and sex, a direct exposure-response relationship with preschool noise was not demonstrated. Short-term variations in typical preschool noise exposure may not measurably affect cochlear function in young children. Future research should refine exposure assessment and recording protocols to reduce variability and improve detection of small physiological changes.

BACKGROUND: The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.

METHODS: The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.

RESULTS: The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3-11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5-22.8] vs. 12.8% [10.7-15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7-15.1] vs. 8.5%[6.8-10.5]).

CONCLUSION: The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.

PURPOSE: There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults.

METHOD: A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure.

RESULTS: Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range.

CONCLUSIONS: There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25114193.

Objective: To study the correlation between P1 latency and the results of clinical language tests (Reynell III and TROG-2), the latter were used as they are recommended for follow-up assessments of children with cochlear implants (Cis) by the Swedish National Quality Register for children with hearing impairment.

Design: A clinical cohort study.Study sample - Cross-sectional and consecutive sampling of 49 children with CIs coming for clinical follow-up assessment from March 2017 - December 2019.

Results: For all children tested, there was a significant negative correlation (Spearman's rho= -0.403, p = 0.011) between hearing age and P1 latency. A significant correlation between P1 latency and the Reynell III result (Spearman's rho =  -0.810, p = 0.015) was found. In the TROG-2 group, there was no significant correlation between their P1 latency and their language test results (Spearman's rho -0.239, p = 0.196).

Conclusion: This method seems to be feasible and easily accepted. The study was conducted in a heterogeneous group of children that we meet daily in our clinic. The results indicated that P1 latency has a negative correlation with language development among our youngest patients fitted with CIs and might be a clinical tool to assess the maturation of central auditory pathways.

This study investigated the impact of bilateral bone conduction (BC) stimulation and sensorineural hearing loss on spatial release from masking, binaural intelligibility level difference, and lateralization. The study involved two groups of adults with mild to moderate sensorineural hearing loss: one group of 21 participants with symmetric hearing loss and another group of nine participants with asymmetric hearing loss. All tests were conducted through BC and air conduction (AC) headsets with non-individualized virtual positions of the sound sources and linear amplification based on individual hearing thresholds. The findings revealed a bilateral benefit for both groups of hearing-impaired individuals, with symmetric hearing loss yielding better results than asymmetric hearing loss. AC stimulation provided approximately twice the benefit in terms of dB compared to BC stimulation. A large part of this benefit originated from a favorable signal-to-noise ratio due to noise reduction from the head shadow. However, binaural processing was present in both hearing-impaired groups with bilateral BC stimulation. The ability to lateralize sounds based on interaural time delays was significantly impaired in participants with both types of hearing loss when stimulation was by BC. Despite these challenges, the study underscores the benefits of bilateral fitting of BC hearing aids, even in individuals with mild to moderate sensorineural hearing loss, whether symmetric or asymmetric.